WASHINGTON -- Giving choline to infants who were exposed in the womb to alcohol may mitigate some of the resulting problems. Prenatal alcohol exposure affects physical and central nervous system development, putting children at risk for fetal alcohol spectrum disorders that at their worst include full-blown fetal alcohol syndrome. These disorders can mean a lifetime of potentially serious problems with learning, attention, motor skills and social behavior. The findings appear in the February issue of Behavioral Neuroscience, which is published by the American Psychological Association (APA).

At San Diego State University, research led by Jennifer Thomas, PhD, is using an animal model to assess the potential therapeutic value of choline. Because scientists have been unable to determine a safe threshold for alcohol consumption during human pregnancy, abstention is the only sure means of prevention. However, warnings about the dangers of drinking during pregnancy either don't reach or aren't heeded by all pregnant women. As a result, researchers are seeking effective remedies to give after birth, when health professionals may be better able to intervene.

Choline plays a number of roles in brain development. It is also a precursor to acetylcholine, a neurotransmitter involved in learning and cognition, among other functions. Choline is available in many foods, such as eggs and liver, and sold over the counter in well-tolerated forms such as lecithin, choline bitartrate or chloride, and phosphatidylcholine. Due to choline's beneficial effects on nervous-system development, women are advised to consume 450 mg a day while pregnant and 550 mg a day while breast feeding (the tolerable upper limit has been set at 3.5 g per day). For infants, 125-150 mg/day is considered adequate during the first year, rising as the child grows older. Choline is added to some prenatal vitamins and baby formulas, and is now added to some children's multivitamins and cereals.

The current study of 170 rats found that giving choline to rat pups exposed to alcohol during the equivalent of the third trimester, when there's a spurt in brain growth, significantly reduced the severity of alcohol-related over-activity and spatial learning deficits. The benefits lasted months after choline treatment, suggesting that choline's effects are long-lasting, say the authors.

Various doses of choline were equally effective, so the researchers think that at least for the rat, as little as 10 mg/kg of weight per day could be effective. Thomas and her colleagues would next like to determine how choline helps and to assess how late in development it can reduce fetal alcohol effects. If choline is to be used clinically, it's important to know when treatment works best.

The authors conclude that extra choline "can alter brain development following a developmental insult. Early dietary interventions may reduce the severity of some fetal alcohol effects, even when administered after birth."

Importantly, the animal data suggest that although early postnatal choline can reduce learning deficits and hyperactivity following early alcohol exposure, it doesn't help reduce motor coordination deficits. Thomas cautions, "Choline is not going to be a panacea for all symptoms of fetal alcohol spectrum disorders. Women need to be continually reminded of the damaging effects of alcohol on the developing fetus."

Previous studies by other researchers have shown that prenatal choline supplementation in rats influences development of the nervous system, especially the brain's cortex and hippocampus. The current study demonstrates the benefits of postnatal choline in rats, making it potentially more useful given the realities of drinking during pregnancy.

Thomas and her colleagues also hope eventually to conduct clinical studies of postnatal choline on humans affected by prenatal alcohol exposure. If the current results with rats are replicated in humans, then infants born to mothers who drank when pregnant might benefit from supplemental choline.

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 145,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

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